Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score ≥15

Huan-Fa Hsieh, Teng-Wei Chen, Chih-Yung Yu, Ning-Chi Wang, Heng-Cheng Chu, Ming-Liang Shih, Jyh-Cherng Yu, Chung-Bao Hsieh

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22 Citations (Scopus)

Abstract

Background: Most liver abscesses resolve after antimicrobial therapy or percutaneous tube drainage (PD). The aim of this study was to evaluate the results of hepatic resection (HR) for patients with pyogenic liver abscesses and an Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥15. Methods: We compared the clinical outcomes of 81 patients with APACHE II scores ≥15 undergoing PD and/or HR. Results: The failure rate (3 of 65) and double-treatment rate (32 of 65) in the PD group were significantly higher than in the HR group (3 of 35 vs 0 of 35; P = .0002). The mortality rate in the PD group was significantly higher than the other 2 groups (14 of 46 vs 2 of 19 and 1 of 16; P = .038). The length of hospital stay was significantly shorter and antibiotic use less in the HR group than in the PD group (P <.05). Conclusions: Aggressive HR for patients with liver abscesses and APACHE II scores ≥15 produced better clinical outcomes. © 2008 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)346-350
Number of pages5
JournalAmerican Journal of Surgery
Volume196
Issue number3
DOIs
Publication statusPublished - 2008
Externally publishedYes

Keywords

  • APACHE II
  • Hepatic resection
  • Pyogenic liver abscess
  • adult
  • aged
  • antibiotic therapy
  • APACHE
  • article
  • female
  • hospitalization
  • human
  • length of stay
  • liver surgery
  • major clinical study
  • male
  • outcome assessment
  • priority journal
  • pyogenic liver abscess
  • statistical significance
  • surgical mortality
  • Aged
  • Aged, 80 and over
  • Female
  • Hepatectomy
  • Humans
  • Liver Abscess, Pyogenic
  • Male
  • Middle Aged
  • Treatment Outcome

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    Hsieh, H-F., Chen, T-W., Yu, C-Y., Wang, N-C., Chu, H-C., Shih, M-L., Yu, J-C., & Hsieh, C-B. (2008). Aggressive hepatic resection for patients with pyogenic liver abscess and APACHE II score ≥15. American Journal of Surgery, 196(3), 346-350. https://doi.org/10.1016/j.amjsurg.2007.09.051